Tara Shajuan Miles, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19424 Issued in SC

Practice address

545 W Butler Rd
Greenville, SC 29607-4833

Phone

(864) 299-1990

Fax

(864) 299-9123

NPI assigned

Apr 18, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC, NC, TX3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  NC

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC, SC

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1215381108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BOXWOOD LN",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296217300",
            "telephone_number": "864-221-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 W BUTLER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074833",
            "telephone_number": "864-299-1990",
            "fax_number": "864-299-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "TARA",
        "middle_name": "SHAJUAN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "19424",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Glenn Milam, MD
• Kelly Breen Milbee, MS
• Tammy Lynn Milburn, PT ASSISTANT
• David Paul Miles, PHARMD.
• Sarah Miles, RN
• Milkweed Counseling LLC
• Emily Melissa Millare, MS, CGC
• Millennium ASC LLC
• Millennium Health and Wellness LLC
• Britney Miller-Bolden

• Family Nurse Practitioner in Greenville, SC
• Providers in Greenville, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.